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What promises to be a nasty tussle between the federal government and several provinces including Saskatchewan over the issue of allowing individuals to privately purchase diagnostic medical imaging services will end up costing them all a lot of money without addressing the real problem.

Editorial: Unproductive battle on health careBack to video

Saskatchewan is only the latest province to permit individuals to buy medical scans, even though it has long allowed injured clients of the Workers Compensation Board and SGI to obtain private scans elsewhere. Considering that British Columbia and Alberta have allowed private MRI/CT services since 1993, Quebec since 1997, Nova Scotia since 2002 and New Brunswick since 2012, Ms. Philpott’s timing suggests it might have more to do with ongoing negotiations on a new federal-provincial health accord than with preserving some long-ignored principles.

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Provincial Health Minister Jim Reiter’s response to his federal counterpart notes that Saskatchewan’s legislation, with its unique requirement for a purchaser of an MRI scan to pay for another for someone on the public wait list, has led to 2,200 diagnostic images done at no cost to the taxpayer. And the two-for-one deal will also apply to CT scans when the new legislation is proclaimed.

While Mr. Reiter is correct that Saskatchewan’s legislation has shortened wait lists for imaging, and Ms. Philpott is certainly correct about queue jumping by those who somehow find the money for speedier access to MRI or CT scans, what’s left out entirely is the tremendous cost to the health system of catering to public demand instead of insisting on evidence-based medicine.

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For instance, the number of MRI images being done over the past seven years has nearly doubled to 34,000 while physicians themselves have begun to question whether many of these tests are even necessary or clinically appropriate. Good health care shouldn’t be measured by the number of scans performed but by whether they make a difference to patient outcomes.

Rather than engage in a battle over whether the provinces are abiding by the Canada Health Act, why not expend some money and effort to support the Choosing Wisely initiative by doctors across North America raising awareness about the overuse of services?

Until politicians begin to see the value of evidence based health care, these jurisdictional squabbles will be the frustrating norm.

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